A Day in Bornou Clinic
By Laura Jepson, Project Reporting & Communications Officer, CAR
November 22, 2013 - Bornou clinic is located on the outskirts of Bria, a small mining town in eastern Central African Republic. International Medical Corps opened the clinic in 2010 because people were traveling up to 46 miles to reach the nearest health facility. We now provide primary health care and nutrition services, free of charge, to almost 7,000 people.
This is a typical day at Bornou clinic:
It is 7am and the veranda of the clinic, which serves as the waiting room, is already starting to fill up with people. The clinic will treat up to 200 patients today, almost half of whom will be children under 5 years old. Malnutrition, malaria, acute respiratory infections, and diarrheal diseases are common. Malaria usually accounts for 30% of the cases seen at the clinic, but at this time of year - the rainy season - malaria is rife and can account for up to 50% of cases.
A mother brings her 6 months old baby, Malazi, to the clinic; he has had a fever for several days. Malaria may be common, but it can be life threatening for young children. All children showing signs of malaria receive a “rapid diagnostic test” as soon as they arrive at the clinic. The test requires just a drop of blood; little Malazi starts to cry loudly as the needle pricks his tiny finger. The test produces a result in less than 20 minutes - one line for negative; two lines for positive. Malazi’s test is positive. Thankfully, it has been caught early and treatment is just a 3-day course of malaria medication.
The next patient is 1-year-old Junior Guimbioblo. He also tests positive for malaria and, following further examination, the nurse diagnoses him with an acute respiratory infection as well. Despite his round face, the measurement of his upper arm—the standard procedure for screening children for malnutrition—is only 11cm, identifying him as severely malnourished. The nurse tells me it is common for children here to have multiple illnesses at the same time. Due to the seriousness of his case, Junior is referred to the stabilization centre at Bria District Hospital, where he will receive a course of therapeutic food known as PlumpyNut to treat his malnutrition and the necessary medication to treat the malaria and respiratory infection.
Today the clinic is exceptionally busy – more than 120 women have brought their children to the routine growth monitoring and malnutrition screening session. The women crouch on mats in the shade while they wait; the small courtyard is buzzing with the sound of their chatter. Our health promoter Dieu Beni uses it as an opportunity to talk to them about good nutrition for the women and their children.
Next door, in the maternity section of the clinic, pregnant women and new mothers wait to see the midwife, Claris, for antenatal and postnatal consultations. In between consultations, Claris tends to two women in the delivery room who are in the early stages of labor, and she has just discharged a woman who had given birth at the clinic during the night.
On average, the clinic deals with up to 10 deliveries a week, but many of these happen at night, which is why the clinic is open 24 hours a day, 7 days a week. After the majority of patients and staff have left for the day, two members of staff stay to cover the night shift. There is no electricity at the clinic, so staff members work by the light of lanterns. Tonight, there are no deliveries.
International Medical Corps has been working in the Vakaga and Haute-Kotto Prefectures in North-East CAR since May 2007 providing basic primary and secondary health care, nutrition care and protection for internally displaced persons, refugees and host populations within these prefectures. These areas are characterized by insecurity and periods of conflict between active rebel groups, which have had a devastating impact on health, education, and water and sanitation services in this part of the country, leaving thousands without access to basic services.